呕血





Star of life caution.svg 维基百科中的醫療相关内容仅供参考，詳見醫學聲明。如需专业意见请咨询专业人士。

body.skin-minerva .mw-parser-output table.infobox caption{text-align:center}




























呕血
分类和外部资源
醫學專科
胃肠学

ICD-10
K92.0

ICD-9-CM
578.0
DiseasesDB
30745
eMedicine
med/3565
MeSH
C23.550.414.788.400

[编辑此条目的维基数据]


呕血（hematemesis）是指患者呕吐出血液的症状，血液的来源为上消化道（即屈氏韧带以上的消化道，包括食管、胃、十二指肠或胰胆等的出血，胃空肠吻合术后的空肠出血也属于上消化道）。呕血经常和咯血（呼吸道出血）相混淆，咯血相对比较多见。




目录






  • 1 表现


  • 2 病因


  • 3 处理


    • 3.1 少量失血


    • 3.2 大量失血




  • 4 相关条目


  • 5 参考资料





表现


呕血的表现可能包括（可以用于和咯血的鉴别）[1]：



  • 有过量饮酒或肝脏疾病史；

  • 有任何食管胃的症状，如恶心，呕吐等；

  • 呕吐物为棕色或黑色；

  • 呕吐物外观像咖啡渣；

  • 出现深色、柏油样大便（即黑便）。



病因


呕血的病因包括[2][3]：



  • 长期和剧烈的干呕（可以引起喉咙或食道的小血管撕裂，患者呕出血丝，又被称为Mallory - Weiss综合征）；

  • 食道或胃内膜受到刺激或侵蚀（如饮酒、药物、中毒等）；

  • 位于胃，十二指肠或食管的出血性溃疡；

  • 吞咽口腔、鼻腔或咽喉出血后呕出；

  • 胃肠道血管疾病，如胃肠道静脉曲张出血；

  • 胃或食管肿瘤；


  • 辐射中毒；


  • 病毒性出血热；


  • 肠胃炎；


  • 胃炎；


  • 消化性溃疡；


  • 慢性病毒性肝炎；

  • 肠血吸虫病（由曼氏血吸虫引起）；


  • 吸烟。



处理


呕血患者应该被视为急诊病人，对生命威胁的最主要区别在于是否有足够的失血引起休克。



少量失血


如果是这种情况，患者一般予以以下处理：使用质子泵抑制剂（如奥美拉唑）、输血（如果血红蛋白水平极低，即小于8.0g/dL 或4.5-5.0mmol/L），在可以安排内镜检查前禁食（临床称为NPO，由禁食的拉丁语nil per os缩写而成）。如果患者进一步呕血、生命体征不稳定，可以使用大口径套管或中心静脉导管开放适当的静脉通道。



大量失血


大量的失血会导致低血容量性休克，以防止心脏骤停采取复苏术是治疗当务之急。同时对患者体内液体和/或血液密切监护，最好使用中央静脉导管。患者紧急进行内镜检查，通常是在手术室里完成。在内镜不能确定出血源的情况下，开腹探查是必须的。呕血病人保证其气道安全是首要任务，尤其是那些意识模糊的病人（如食管静脉曲张破裂的肝性脑病患者），采用气管插管的方式可能是拯救生命的一个选择。



相关条目



  • 上消化道出血

  • 便血



参考资料





  1. ^ What is Hematemesis? Vomiting Up Blood


  2. ^ Vomiting blood - Overview


  3. ^ Vomiting blood






规范控制

  • NDL: 00573184



-

Popular posts from this blog

Guess what letter conforming each word

Image
6 $begingroup$ This is an entry in the Fortnightly Topic Challenge #41: Short and Sweet. 1 letter only could be mean anything . With an additional letter in front , could be used as medicine component and something you definitely learn or at least heard once. Add another letter in front , you would possibly hear that many times . Add an additional letter in front , you would found an independent country . With an additional letter, in the end , you would found something related to apple . Add another letter in the end , you would found something bad . Hint: Each letter is unique . word knowledge letters chemistry share | improve this question ...
Read more

Port of Spain

Image
For ports in the country of Spain, see List of ports in Spain. City in City of Port of Spain, Trinidad and Tobago Port of Spain City City of Port of Spain Top to bottom (left to right): Skyline of Port of Spain from Gulf of Paria; National Academy for the Performing Arts, Independence Square, Eric Williams Plaza; MovieTowne, Port of Port of Spain Motto(s):  "We Gather Strength As We Go Along" Port of Spain Coordinates: 10°40′N 61°31′W  /  10.667°N 61.517°W  / 10.667; -61.517 Coordinates: 10°40′N 61°31′W  /  10.667°N 61.517°W  / 10.667; -61.517 Country   Trinidad and Tobago Jurisdiction City of Port of Spain Settled 1560 Incorporated (town) 1853 Incorporated (city) 1914 Government  • Mayor Joel Martinez  • Governing body City Corporation Area [1]  • City 12 km 2 (5 sq mi) Elevation [2] 66 m (217 ft) Population (2011) [1]  • City 37,074  • Rank 3rd  • Density 3,090/km 2 (8,000/sq mi)...
Read more

Run scheduled task as local user group (not BUILTIN)

Image
0 I am trying to run a scheduled task with User Group (not a single user). This is working fine when I in the field "when running a task, use the following user account:" insert BUILTIN User Group (for example: Administrators or Users). But when I try it with the created Local User Group (example: TestGroup) it is not working. The Users in the TestGroup are the same as in the Administrators group. What could be the problem? Are there some restrictions to the Created User Group compared to BUILTINUsers? scheduled-tasks taskscheduler windowstaskschedule share | improve this question asked Nov 15 '18 at 15:36 Far...
Read more